oxytocin and Brain-Edema

We report of a woman with post-partum cerebral angiopathy (PCA), in whom we repetitively performed transcranial Doppler sonography (TCD), MR imaging (MRI), and MR angiography (MRA) to evaluate the underlying pathophysiology. A 31-year-old woman, Gemini pregnant, complained of severe throbbing frontal headache four days after an uneventful delivery by Cesarean section. Blurred vision occurred eight days after delivery, followed by three generalized tonic-clonic seizures. Neurological examination revealed a somnolent woman without focal neurological deficits. At the day of the seizures increased flow velocities and disturbed flow were observed in the right posterior and anterior cerebral artery on transcranial Doppler (TCD). MRI showed infra- and supratentorial patchy hyperintensities in T2-weighted images and in the FLAIR sequence. Diffusion-weighted imaging revealed corresponding multi-focal hyperintense areas indicating increased diffusion and MRA showed a diffuse multisegmental narrowing of all pial arteries. MRI at day 10 was completely normal, but MRA still revealed vascular narrowing in the right posterior cerebral artery. General slight flow accelerations in all basal arteries occurred after 10 days and lasted for three weeks. PCA is apparently associated with a vascular narrowing causing cerebral ischemia with increased diffusion. Later reactive cerebral hyperperfusion is observed. Vascular narrowing and cerebral hyperperfusion still persist after MRI has normalized.

Topics: Acetates; Adult; Amines; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Aspirin; Brain Edema; Cerebral Angiography; Cerebral Arteries; Cerebral Hemorrhage; Cerebrovascular Circulation; Cyclohexanecarboxylic Acids; Echoencephalography; Eclampsia; Female; Gabapentin; gamma-Aminobutyric Acid; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Observer Variation; Oxytocin; Postpartum Period; Pregnancy; Sensitivity and Specificity; Time Factors; Ultrasonography, Doppler, Transcranial

The present study was designed to determine the effect of different doses of oxytocin (OXT) on neuronal injury, spatial memory, blood-brain barrier (BBB) integrity and to explore possible underlying molecular mechanisms in the early stage of stroke in mice. Stroke model was generated by middle cerebral artery occlusion (MCAO) for 60 min and 24 h reperfusion in mice. OXT at doses of 1, 2, 4 and 8 IU/per mouse was administrated intranasally at the beginning of brain ischemia. Brain injury, BBB integrity, and spatial memory were evaluated by standard methods. Changes in the expression of nuclear factor-kappa B (NF-κB), and TUNEL positive cell were detected by immunohistochemistry. The levels of vascular endothelial growth factor (VEGF), aquaporin-4 (AQP4) and brain-derived neurotrophic factor (BDNF) proteins were determined by western blotting and ELISA methods. OXT at doses of 4 and 8 IU/per mouse reduced the infarct size by 42% and 52%, respectively, and improved spatial memory function (p < 0.001). OXT (8 IU/per mouse) significantly reduced brain edema, BBB disruption and upregulated the AQP4 expression (p < 0.001). Finally, OXT significantly diminished the number of apoptotic, NF-κB positive cells and enhanced the expression of BDNF and VEGF proteins in the brain tissue (p < 0.001). These findings provide important evidences that OXT significantly suppresses neuronal damage in the early stage of stroke by inhibiting apoptotic and NF-κB signaling pathway, increasing the expression of VEGF, AQP4 and BDNF proteins and reducing the BBB leakage.

Topics: Animals; Aquaporin 4; Blood-Brain Barrier; Brain Edema; Brain-Derived Neurotrophic Factor; Cerebral Infarction; In Situ Nick-End Labeling; Infarction, Middle Cerebral Artery; Ischemic Stroke; Male; Mice; Nerve Tissue Proteins; NF-kappa B; Oxytocin; Signal Transduction; Single-Blind Method; Spatial Memory; Vascular Endothelial Growth Factor A

Topics: Abortion, Induced; Adult; Brain Edema; Female; Humans; Hyponatremia; Oxytocin; Pregnancy; Pregnancy Trimester, Second; Seizures; Water Intoxication

Topics: Adrenocorticotropic Hormone; Betamethasone; Brain Edema; Cerebrovascular Disorders; Female; Glycerol; Humans; Male; Oxytocin; Retrospective Studies

Topics: Abortion, Induced; Adolescent; Adult; Brain Edema; Edema; Female; Humans; Hypotonic Solutions; Oxytocin; Seizures; Sodium Chloride; Water Intoxication

Topics: Abortion, Spontaneous; Adult; Brain Edema; Electroencephalography; Female; Humans; Injections, Intravenous; Oxytocin; Pregnancy; Seizures; Water Intoxication; Water-Electrolyte Balance

Topics: Adult; Brain Edema; Epilepsy, Tonic-Clonic; Female; Humans; Labor, Induced; Obstetric Labor Complications; Oxytocin; Pregnancy; Water Intoxication

Topics: Adrenocorticotropic Hormone; Adult; Aged; Angiography; Brain Edema; Cerebrovascular Disorders; Craniocerebral Trauma; Echoencephalography; Electroencephalography; Electrooculography; Female; Humans; Male; Middle Aged; Oxytocin; Perfusion; Vasopressins; Water-Electrolyte Balance

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Astrocytoma; Brain Diseases; Brain Edema; Brain Neoplasms; Electroencephalography; Epilepsy; Glioma; Humans; Middle Aged; Neoplasm Metastasis; Oxytocin

Topics: Arginine Vasopressin; Brain Edema; Drug Therapy; Humans; Neurosurgery; Neurosurgical Procedures; Oxytocin; Physiology; Syndrome; Vasopressins